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Louisiana rates for HCPCS 64636

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $1,148.15 / $3,467.37
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$602.56 / $977.24 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $190.55 / $776.25
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$85.11 / $154.88 / $831.76
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$77.62 / $100.00 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $870.96 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $112.20 / $371.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $524.81 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $158.49 / $338.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $512.86 / $1,258.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $144.54 / $281.84